Soc Wrk 721 EXEMPTION REQUEST



|Soc Wrk 721 EXEMPTION REQUEST |

|If you are interested in applying for an exemption for Field Course 721, the following form must be filled out and returned to the Graduate Field Office, Enderis 1075, |

|prior to the semester in which you enroll as a full-time student and/or are assigned to a field placement. |

| |

|After the Director of the Field Education Program has reviewed the Field Exemption Request, a copy will be returned to you for your records indicating the status of your |

|request. |

|INDIVIDUAL FIELD EXEMPTION REQUEST: Social Work 721 |

|Date of Application:       |

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|Criteria: The criteria for an exemption of Social Work Field Course 721 are based on the following guidelines. Please mark one of the 4 categories to indicate which |

|criteria applies to your exemption request. |

| |

|a) Graduation from an accredited BSW program within the past five years. Eligibility for exemption from Social Work 721, Field Education I, applies only when a minimum |

|of a “B” average has been achieved in field courses. |

|Date of Graduation:       Name of School:       |

| |

|b) Within the past five years, satisfactory full-time employment in a social work position (following completion of the bachelor’s degree) for a minimum of two years with|

|direct supervision provided by an MSW. Please provide the following with the Exemption Request form: |

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|1) A job description of the social work position(s) relevant to this exemption request |

|2) A letter of reference from your MSW social work supervisor(s) which must include a statement |

|indicating the type of social service activities in which you were involved, an evaluation statement |

|of your social work performance, the date of your employment and the specific time period during which you |

|received MSW supervision. |

| |

|c) Full-time employment as a social worker following completion of a BSW for no less than two years within a five-year period prior to the date you begin the MSW program.|

|You must have a BSW from an accredited program. (There are no time requirements as to when the BSW degree was conferred). Please provide the following with the Exemption|

|Request form: |

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|1) A job description of the social work position(s) relevant to this exemption request |

|2) A letter of reference from your immediate supervisor(s) which must include a performance evaluation or |

|statement of your performance within the agency and the dates of your employment. |

| |

|d) Completed a supervised field practicum in a human services agency providing direct client services for a minimum of 260 hours. Field Instructor must have a degree in |

|social work or a related field with a minimum of two years of professional experience. Please provide the following with the Exemption Request form: |

|Field practicum completed evaluation signed by the agency Field Instructor with verification of the hours completed and the Field Instructor credentials. |

|Field course syllabus |

Name:       Student I.D.#       Telephone:      

Address: Street:      

City:       State:       Zip:      

UWM Email Address:      

Recommendation of Director of Field Program: Approved Denied

_____________________________________ ____________

Signature: Director of Field Programs Date

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